Healthcare Provider Details

I. General information

NPI: 1528007564
Provider Name (Legal Business Name): PHYSICIANS PLUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 MENTOR AVE
PAINESVILLE OH
44077-3105
US

IV. Provider business mailing address

263 MENTOR AVE
PAINESVILLE OH
44077-3105
US

V. Phone/Fax

Practice location:
  • Phone: 440-354-5643
  • Fax: 440-354-5645
Mailing address:
  • Phone: 440-354-5643
  • Fax: 440-354-5645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number35-03-9102-L
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number233
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4912
License Number StateOH

VIII. Authorized Official

Name: PAUL CARDINALE JR.
Title or Position: OFFICE MANAGER
Credential:
Phone: 440-354-5643